JP2004147902A

JP2004147902A - Suturing prosthesis aid

Info

Publication number: JP2004147902A
Application number: JP2002317141A
Authority: JP
Inventors: Yasuhiro Ueno; 康弘上之; Yasuhiro Sato; 恭裕佐藤
Original assignee: Gunze Ltd
Current assignee: Gunze Ltd
Priority date: 2002-10-31
Filing date: 2002-10-31
Publication date: 2004-05-27
Anticipated expiration: 2022-10-31
Also published as: JP4409161B2

Abstract

<P>PROBLEM TO BE SOLVED: To provide a suturing prosthesis aid which can be used in a surgical treatment to be applied for an automatic suturing instrument. <P>SOLUTION: This suturing prothesis aid comprises a cylindrical body made of a cloth of an in vivo lysable and absorbable material alone or in combination with a stretchable knit textile, wherein the cloth of the in vivo lysable and absorbable material is previously provided with a pair of ripping seams as printed by a sewing machine. <P>COPYRIGHT: (C)2004,JPO

Description

【０００１】
【産業上の利用分野】
本発明は、外科手術等における自動縫合器に用いて好適な縫合補綴材の提供に関する。
【０００２】
【従来の技術】
従来、多数のステープルを埋入したホッチキスタイプの自動縫合器は組織の切除等に多用されるが、肺等への適用においては縫合部からの空気漏れの問題、また、軟弱組織への適用においては組織の損傷、断裂等の問題を生じることがあった。かかる問題に対して、本出願人は先に、ステープル部に装着して使用する筒状の縫合補綴材について提案した。（特許文献１、２参照）
【０００３】
【特許文献１】
実用新案登録第２６０４０２５号公報
【特許文献２】
特許第３１３６３９２号公報
【０００４】
上記の公知例において、例えば生体内分解吸収性素材よりなる長方形状の不織布を筒状に形成する際、耳端部を粗く仮縫いして筒状体に形成するとか、或いは生体内分解吸収性素材よりなる長方形状の不織布とポリウレタン弾性糸にナイロン糸をカバリングした糸使いにより編成した長方形状の伸縮性編地であるパワーネット生地の両者を組み合わせて筒状に形成する際、その耳端部をぐし縫い（粗縫い）して筒状体に形成し、次いでこれらの筒状体を自動縫合器に装着し、手術時に一対の筒状に形成した不織布間で又は不織布と伸縮性編物地で筒状体に形成したものにおいて一対の不織布間で保持された人体組織に対し、ステープルの締金操作並びにカッター操作を行って病変部と正常組織部分に分断し、更に仮縫い又はぐし縫いを施した縫着部の縫糸端を引っ張ることにより、前記筒状体が正常組織部側に残存する不織布部分と病変部側に連結された伸縮性編物等の部分とに分断され、病変部側はパワーネット生地等と共に対外に撤去される旨の内容が記載されている。
また、切断を容易にするためのミシン目を中央部に設けた構成も示される。
【０００５】
【発明が解決しようとする課題】
しかしながら上記のように仮縫い又はぐし縫いを施した縫着部の縫糸端を引っ張って正常組織部側に残存する不織布部分と病変部側に連結された状態の伸縮性編物等の部分とに分断するにあたり、スムーズに糸が抜けなかったり、それによって組織を傷つけたりする等の問題が生じる恐れがあった。
【０００６】
【課題を解決するための手段】
本発明は、上記のような課題を解決するために生体内分解吸収性素材よりなる長方形状の布状体に予め一対のミシン目状引き裂き用切断部を設けると共に、同布状体の耳端部を縫着などの手段により筒状体に形成し、手術時に縫糸端の延出部を引っ張ることにより、前記の引き裂き用切断部の分断が容易に行われる構成としたことに特徴を有するものである。
即ち、該構成により縫合器によるファイアーカット後、ステープルライン補強部位とそれ以外の部分との分断操作が容易且つ正確に行えるものである。
【０００７】
また、別の構成として、上記のように予め一対のミシン目状引き裂き用切断部を設けた生体内分解吸収性素材による長方形状の布状体とは別に伸縮性編織物地による長方形状の布状体を準備し、両者の耳端部を縫着などの手段を介して筒状体に形成することにより、高価な生体内分解吸収性素材の使用量を少量とし、生体内分解吸収性素材自身のもつ伸縮性と伸縮性編織物地素材のもつ伸縮性によって自動縫合器への装着性をより改善し、位置ずれすることがなく、生地の伸縮性による緊張状態により、より安価により切断性を高めたものである。
【０００８】
【発明の実施の形態】
生体内分解吸収性素材よりなる長方形状の布状体に一対のミシン目状引き裂き用切断部を設ける場合、その切断部の切断方向は、筒状体の切断方向と同一方向に連続し、端部から端部にわたって設ける。或いは、筒状体の外周面上において湾曲状を描くように設けてもよい。
なお、該引き裂き用ミシン目は、例えば、凸部を切断歯、凹部を溝としたカッター等を用い、これを押圧することにより形成することができる。ミシン目のピッチ、大きさは特に限定しないが、歯長と溝長が比較的短いピッチの細かいもの、歯長が長く溝長の短いものは引き裂き性に優れる。しかしながら、ミシン目の作成位置によって引き裂き性が異なるので、ミシン目サイズ、ピッチは適宜選択する。
また、かかるミシン目は、引き裂きやすいようパラレルに１対設ける事を原則とするが、必要に応じて更に増やすこともできる。
【０００９】
生体内分解吸収性素材による布状体としては、ポリグリコール酸、ポリ乳酸、グリコール酸と乳酸の共重合体、乳酸とカプロラクトンの共重合体、グリコール酸とカプロラクトンの共重合体あるいはそれらの混合物、更にはポリパラジオキサノン、ポリカプロラクトン、キチン等、既に医用材料として適用されている素材の編地、織地、不織布、フィルム、シート、スポンジシート等を例示できるが、特に柔軟性、通気性、腰、厚さ、吸血性、ステープルライン形成性、加水分解性等の面より、ポリグリコール酸を素材とした不織布が好適な素材として例示できる。なお、かかる不織布は、ニードルパンチ、メルトブロー等、公知の方法によって製造されたもので、特に不織布単独で筒状の縫合補綴材を提供する場合は、自動縫合器への装着性を損なわないようある程度の伸縮性を有するものが好ましい。かかる生体内分解吸収性素材は、そのまま体内に放置して異物として残留しない特徴を有する。
【００１０】
引き裂き用切断部を設けた生体内分解吸収性素材による布状体と組み合わせて筒状体を形成するようにした伸縮性を有する編織物地としては、その編織物地の生地組織の中に、例えばゴム糸、ポリウレタン系弾性糸、捲縮性加工糸、嵩高加工糸等が適宜交編、交織されており、縦、横方向に伸縮性を有するものが好ましく、またその組織については特に限定しないが、裁断作業や、筒状体形成時の縫製作業等の容易性、更に形態安定性等の面から例えばポリウレタン糸にナイロン糸をカバリングして得た伸縮性糸を用いて経編地に編成したパワーネット生地が特に好適な例として例示できる。
【００１１】
生体内分解吸収性素材からなる長方形状の布状体を用いて筒状体を形成する場合は、縫合器の外周サイズに合わせて裁断された１枚の生地を丸めて筒状にする場合と、２枚の生地を重ねあわせ、両端を接合する場合がある。かかる接合は、縫製、溶融接着、接着剤等任意の手段によって行われ、端部を重ね合わせるときは、平坦状に重合する場合と、手合わせ状に重合する場合がある。縫製によってこれを接合する場合は、縫着部前後の縫糸端は、ミシン目状引き裂き用切断部を引き裂いて分断するための引き裂き用糸として、適宜の長さに延出しておくのが望ましい。この場合、１枚の生地にて筒状を構成する場合、１対のミシン目は、該縫合部の両端に位置するよう配置する必要がある。縫合作業が完了し、ファイアーカットが行われた後において、かかる糸端を上方に引っ張ることにより、また、両端を縫合し、筒状にした場合、一対の引き裂き用糸を同時に把持して上方へ引っ張ることにより、ミシン目状引き裂き用切断部が、順次引き裂かれていき、分断されるのである。
なお、筒状体を形成する際、溶融接着又は接着剤によって形成する場合は、引き裂き用糸として溶融接着、接着剤部の前或いは後端部に適宜の長さのコード糸を接着するか、又は筒状体の廃棄、撤去用周面部の外表面上に適宜の長さのコード糸を溶融接着又は接着剤等の手段によって接着しておくことが望ましい。
縫製による縫糸、融着接着、接着剤により一体化するコード糸は、非分解性、分解性を問わず任意であるが、かかる操作に耐え得る強度を有することが望まれる。
また、その糸端はループ上につながっていてもよい。
【００１２】
本発明による縫合補綴材が適用される開胸用の自動縫合器としては、Ｕ．Ｓ．ＳＵＲＧＩＣＡＬ社製のマルチファイヤーＧＩＡ８０、マルチファイヤーＧＩＡ６０、ＧＩＡ５０Ｐ、ＧＩＡ９０Ｐ、エチコン社製のプロキシメイトリニアカッター５５ｍｍ及び７５ｍｍ等が例示できる。また胸腔鏡用の自動縫合器としては、Ｕ．Ｓ．ＳＵＲＧＩＣＡＬ社製のエンドＧＩＡ▲２▼３０、エンドＧＩＡ▲２▼４５、エンドＧＩＡ▲２▼６０、エチコン社製のエンドパスエンドカッターＥＴＳ４５、ＥＺ４５等が例示できる。これらの縫合器への適用に際してはステープル内臓のカートリッジ部とステープル受け溝を有するアンビル部に被包させるという簡単な操作によって行うことができる。
【００１３】
以下、本発明による縫合補綴材の実施例について図面をもとに説明するが本発明はこれに限定されない。
【実施例１】
図１は本発明における実施例１による縫合補綴材１０を示したもので、生体内分解吸収性素材からなる長方形状の不織布１１を丸めて筒状体１２を形成し、且つ両耳端部を平らに重合した状態で同重合部１３を手縫いにより、ぐし縫い１４（波縫い、粗縫い）を施してあり、且つその縫糸の両端部をそれぞれ延出して縫糸延長部１５、１６を形成してある。１７，１７は夫々筒状の不織布１１に予め設けたミシン目状の引き裂き用切断部で、筒状体１２の軸方向と平行状で且つ直線状に形成してある。自動縫合器に前記縫合補綴材１０を装着してファイアーカットした後、一対の縫糸延長部１５或いは１６を手作業で上方に引っ張り上げることにより、引き裂き用切断部１７，１７が同時に引き裂かれ、ステープルライン補強部位として残る部分（下側部分）と除去する部分（縫糸を含む上部）の分断を容易に行うことができる。
【００１４】
【実施例２】
図２は本発明における実施例２による縫合補綴材２０を示したもので、生体内分解吸収性素材からなる長方形状の不織布２１を丸めて筒状体２２を形成し、且つ両側縁部を手合わせ状に重合した状態で同重合部２３に対して手縫いにより、縫製２４を施してあり、且つその縫糸の両端部をそれぞれ延出して縫糸延長部２５、２６を形成してある。２７，２７は夫々筒状の不織布２１に予め設けたミシン目状の引き裂き用切断部で、筒状体２２の軸方向と平行状で且つ直線状に形成してある。尚、自動縫合器に前記縫合補綴材２０を装着してファイアーカットした後、一対の縫糸延長部２５或いは２６を夫々手作業で引っ張って持ち上げることにより、引き裂き用切断部２７，２７が同時に引き裂かれ、ステープルライン補強部位（下側部分）とそれ以外の除去される部分（縫糸を含む上部）の分断を容易に行うことができる。
【００１５】
【実施例３】
図３は本発明における実施例３による縫合補綴材３０を示したもので、生体内分解吸収性素材からなる長方形状の不織布３１を丸めて筒状体３２を形成し、且つ両側縁部を手合わせ状に重合した状態で同重合部３３に対して手縫いにより、ぐし縫い３５を施してあり、且つその縫糸の両端部をそれぞれ延出して縫糸延長部３６、３７を形成してある。３８，３８は夫々筒状の不織布３１に対して予め設けたミシン目状の引き裂き用切断部で、筒状体３２の外周面上で湾曲状に形成してある。尚、図示略の自動縫合器に縫合補綴材３０を装着してファイアーカットした後、一対の縫糸延長部３５或いは３６を夫々手作業で引っ張って持ち上げることにより、引き裂き用切断部３８、３８が同時に引き裂かれ、ステープルライン補強部位（下側部分）とそれ以外の除去される部分（縫糸を含む上部）の分断を容易に行うことができる。
【００１６】
【実施例４】
図４は本発明における実施例４による縫合補綴材４０を示したもので、生体内分解吸収性素材からなる長方形状の不織布４１を丸めて筒状体４２を形成し、且つ両耳端部を平らに重合した状態で同重合部４３に対して通常のミシンにより、縫着４５を施してあり、且つそのミシン糸の両端部をそれぞれ延出して下糸及び上糸による縫糸延長部４６、４６、４７、４７夫々２本を形成してある。４８，４８は夫々筒状の不織布４１に対して予め設けたミシン目状の引き裂き用切断部で、筒状体４２の軸方向と平行状で且つ直線状に形成してある。尚、図示略の自動縫合器に縫合補綴材４０を装着してファイアーカットした後、一対の縫糸延長部４６或いは４７を夫々手作業で引っ張って持ち上げることにより、引き裂き用切断部４８、４８が同時に引き裂かれ、ステープルライン補強部位（下側部分）とそれ以外の除去される部分（縫糸を含む上部）の分断を容易に行うことができる。
【００１７】
【実施例５】
図５は本発明における実施例５による縫合補綴材５０を示したもので、生体内分解吸収性素材からなる長方形状の不織布５１を丸めて筒状体５２を形成し、且つ両耳端部を平らに重合した状態で同重合部５３に対してヒータ等を押圧して溶融接着５５を施してあり、且つその溶融接着部５５の両端部に適宜長さのコード糸を溶融接着して引っ張り用糸５６、５７を夫々形成してある。５８，５８は夫々筒状の不織布５１に対して予め設けたミシン目状の引き裂き用切断部で、筒状体５２の軸方向と平行状で且つ直線状に形成してある。尚、図示略の自動縫合器に上記縫合補綴材５０を装着してファイアーカットした後、一対の引っ張り用糸５６、５７を夫々手作業で引っ張って持ち上げることにより、引き裂き用切断部５８、５８が同時に引き裂かれ、ステープルライン補強部位（下側部分）とそれ以外の除去される部分（縫糸を含む上部）の分断を容易に行うことができる。
【００１８】
【実施例６】
図６は本発明における実施例６による縫合補綴材６０を示したもので、縦方向の長さが同一で、且つ幅方向の長さが大である長方形状の生体内分解吸収性素材による不織布６１と幅方向の長さを小とした伸縮性パワーネット生地６２を用いて筒状体６３を形成するもので、不織布６１及びパワーネット生地６２の夫々の両耳端部を手合わせ状に重合した状態で同重合部６４、６４に対して手縫いにより、ぐし縫い６５、６５を夫々施して筒状体６３を形成するのである。また６６、６７は縫糸の両端部をそれぞれ延出して形成した縫糸延長部であり、６８、６８は幅方向（周方向）の寸法を大とした不織布６１に予め設けた一対のミシン目状引き裂き用切断部で、筒状体６３の軸方向と平行状で且つ直線状に形成してある。尚、自動縫合器に前記縫合補綴材６０を装着してファイアーカットした後、一対の縫糸延長部６６或いは６７を夫々手作業で引っ張って持ち上げることにより、引き裂き用切断部６８，６８が同時に引き裂かれ、ステープルライン補強部位（下側部分）とそれ以外の除去される部分（縫糸を含む上部）の分断を容易に行うことができる。
【００１９】
【実施例７】
図７は本発明における実施例７による縫合補綴材７０を示したもので、縦方向及び幅方向の長さをほぼ同一にした長方形状の生体内分解吸収性素材による不織布７１と伸縮性パワーネット生地７２を介して筒状体７３を形成し、且つ不織布７１とパワーネット生地７２の夫々の両耳端部を手合わせ状に重合した状態で同重合部７４、７４に対して通常のミシンにより、縫着７５、７５を夫々施して筒状体７３を形成するのである。また７６、７７は夫々縫糸の両端部をそれぞれ延出して形成した縫糸延長部であり、７８、７８は不織布７１において予め設けた一対のミシン目状引き裂き用切断部で、筒状体７３の軸方向と平行状で且つ直線状に形成してある。尚、自動縫合器に前記縫合補綴材７０を装着してファイアーカットした後、一対の縫糸延長部７６或いは７７を夫々手作業で引っ張って持ち上げることにより、引き裂き用切断部７８，７８が同時に引き裂かれ、ステープルライン補強部位（下側部分）とそれ以外の除去される部分（縫糸を含む上部）の分断を容易に行うことができる。
【００２０】
【実施例８】
図８は本発明における実施例８による縫合補綴材８０を示したもので、縦方向及び幅方向の長さをほぼ同一にした長方形状の生体内分解吸収性素材による不織布８１と伸縮性パワーネット生地８２を介して筒状体８３を形成するもので、不織布８１とパワーネット生地８２の夫々の両耳端部を手合わせ状に重合した状態で同重合部８４、８４に対して適宜のヒータ等を押圧し、溶融接着８５を施して筒状体８３に形成し、更に体外に撤去される側のパワーネット生地８２の外周面上に適宜長さのコード糸８６を適宜に溶融接着してある。８７、８７は不織布８１に予め設けたミシン目状引き裂き用切断部で、筒状体８３の軸方向と平行状で且つ直線状に形成してある。尚、自動縫合器に上記縫合補綴材８０を装着してファイアーカットした後、コード糸８６を手作業で引っ張って持ち上げることにより、引き裂き用切断部８７、８７が同時に引き裂かれ、ステープルライン補強部位（下側部分）とそれ以外の除去される部分（縫糸を含む上部）の分断を容易に行うことができる。
【００２１】
【発明の効果】
本発明は、特にステープルタイプの自動縫合器を用いた手術において切除部からの空気漏れ、或いは軟弱な組織の断裂等を防止できるという特徴ならびに材料自身が生体内分解吸収性であるため体内に長期に渡り残存しないという特徴を有すると共に、一対のミシン目状引き裂き用切断部を設けたことによってステープルライン補強部位とそれ以外との分断を容易に行える効果がある。
また比較的伸縮性のある生体内分解吸収性素材による不織布などを用いた場合は、単独の使用の場合でもその伸縮性によって自動縫合器への装着や修正操作が容易となり、また、一旦装着された後においては、その伸縮力により位置ずれすることがなく、また、ステープルにて固定した後のカッティング操作においても張力が掛かっているため、容易に切断できる効果がある。
生体内分解吸収性素材に伸縮性がない場合は、伸縮性のある素材との組み合わせにより上記と同様の装着性を得ることができカッティング操作においても容易に切断できる効果がある。
【図面の簡単な説明】
【図１】本発明の第１実施例によって得られた縫合補綴材の概略斜視図である。
【図２】本発明の第２実施例によって得られた縫合補綴材の概略斜視図である。
【図３】本発明の第３実施例によって得られた縫合補綴材の概略斜視図である。
【図４】本発明の第４実施例によって得られた縫合補綴材の概略斜視図である。
【図５】本発明の第５実施例によって得られた縫合補綴材の概略斜視図である。
【図６】本発明の第６実施例によって得られた縫合補綴材の概略斜視図である。
【図７】本発明の第７実施例によって得られた縫合補綴材の概略斜視図である。
【図８】本発明の第８実施例によって得られた縫合補綴材の概略斜視図である。
【符号の説明】
１０縫合補綴材
１１不織布
１２筒状体
１３重合部
１４ぐし縫い
１５、１６縫糸延長部
１７引き裂き用切断部[0001]
[Industrial application fields]
The present invention relates to the provision of a suture prosthesis suitable for use in an automatic suturing device in a surgical operation or the like.
[0002]
[Prior art]
Conventionally, a stapler type automatic suturing device in which a large number of staples are embedded is frequently used for tissue excision, etc., but in application to the lung, etc., there is a problem of air leakage from the sutured part, and in application to soft tissue. May cause problems such as tissue damage and tearing. In response to this problem, the present applicant has previously proposed a tubular suture prosthesis material that is used by being attached to a staple portion. (See Patent Documents 1 and 2)
[0003]
[Patent Document 1]
Utility Model Registration No. 2604025 [Patent Document 2]
Japanese Patent No. 3136392 [0004]
In the above known example, for example, when a rectangular nonwoven fabric made of a biodegradable absorbent material is formed into a cylindrical shape, the ear end portion is roughly sewed to form a cylindrical body, or the biodegradable absorbent material When forming a cylindrical shape by combining both a rectangular nonwoven fabric made of polyurethane and a power net fabric, which is a rectangular stretch knitted fabric knitted by covering nylon elastic yarn with polyurethane elastic yarn, Formed into a cylindrical body by combing (rough stitching), and then mounting these cylindrical bodies on an automatic suturing device, between the nonwoven fabric formed into a pair of cylindrical shapes at the time of surgery, or with a nonwoven fabric and a stretch knitted fabric The human tissue held between a pair of non-woven fabrics formed in the shape was subjected to staple clamping operation and cutter operation to divide into the lesioned part and normal tissue part, and further subjected to temporary stitching or comb stitching By pulling the suture end of the landing part, the cylindrical body is divided into a non-woven fabric part remaining on the normal tissue part side and a stretch knitted part connected to the lesion part side, and the lesion part side is a power net fabric. The content of the removal to the outside is described.
Further, a configuration in which a perforation for facilitating cutting is provided in the central portion is also shown.
[0005]
[Problems to be solved by the invention]
However, as described above, the suture end of the sewn portion subjected to temporary stitching or comb stitching is pulled to divide into a nonwoven fabric portion remaining on the normal tissue portion side and a stretched knitted fabric portion or the like connected to the lesioned portion side. In such a case, there is a risk that the thread may not come off smoothly, and thereby the tissue may be damaged.
[0006]
[Means for Solving the Problems]
In order to solve the above-described problems, the present invention provides a pair of perforated tear cutting portions in advance in a rectangular cloth-like body made of a biodegradable absorbent material, and the ear ends of the cloth-like body. The part is formed into a cylindrical body by means such as sewing, and by pulling the extended part of the suture thread during surgery, the tearing cutting part can be easily divided. It is.
That is, with this configuration, after the fire is cut by the suturing device, the operation for dividing the staple line reinforcing portion and the other portions can be easily and accurately performed.
[0007]
In addition, as another configuration, a rectangular cloth made of a stretch knitted fabric separate from the rectangular cloth made of a biodegradable absorbent material provided with a pair of perforated tearing cutting portions in advance as described above The amount of the expensive biodegradable absorbent material is reduced to a small amount by preparing the body and forming both ear ends into a cylindrical body via means such as sewing. Due to its own elasticity and the elasticity of the elastic knitted fabric material, it improves the attachment to the automatic suturing device, does not shift, and is less expensive due to tension due to the elasticity of the fabric. It is a thing that raised.
[0008]
DETAILED DESCRIPTION OF THE INVENTION
When a pair of perforated tearing cutting parts are provided in a rectangular cloth body made of biodegradable absorbent material, the cutting direction of the cutting parts is continuous in the same direction as the cutting direction of the cylindrical body, Provided from part to end. Or you may provide so that curved shape may be drawn on the outer peripheral surface of a cylindrical body.
The tear perforation can be formed by, for example, using a cutter having a convex portion as a cutting tooth and a concave portion as a groove and pressing the cutter. The pitch and size of the perforations are not particularly limited, but fine ones having a relatively short tooth length and groove length and those having a long tooth length and a short groove length are excellent in tearability. However, the tearability varies depending on the perforation creation position, so the perforation size and pitch are selected as appropriate.
In principle, a pair of such perforations are provided in parallel to facilitate tearing, but can be further increased as necessary.
[0009]
Examples of the cloth-like body made of biodegradable absorbent material include polyglycolic acid, polylactic acid, a copolymer of glycolic acid and lactic acid, a copolymer of lactic acid and caprolactone, a copolymer of glycolic acid and caprolactone, or a mixture thereof. Further examples include knitted fabrics, woven fabrics, non-woven fabrics, films, sheets, sponge sheets and the like that have already been applied as medical materials such as polyparadioxanone, polycaprolactone, chitin, etc. In view of thickness, blood absorbency, staple line formation, hydrolyzability, and the like, a nonwoven fabric made of polyglycolic acid can be exemplified as a suitable material. Such a nonwoven fabric is manufactured by a known method such as needle punching, melt blowing, and the like, and in particular, when providing a tubular suture prosthesis material alone, the nonwoven fabric is provided to some extent so as not to impair the attachment to an automatic suturing device. What has the elasticity of these is preferable. Such a biodegradable and absorbable material has a characteristic that it is left as it is in the body and does not remain as a foreign substance.
[0010]
As a knitted fabric having elasticity that forms a cylindrical body in combination with a cloth-like body made of a biodegradable absorbent material provided with a tearing cutting part, in the fabric structure of the knitted woven fabric, For example, rubber yarns, polyurethane-based elastic yarns, crimped processed yarns, bulky processed yarns and the like are appropriately knitted and woven, and those having stretchability in the vertical and horizontal directions are preferable, and the structure is not particularly limited However, from the viewpoint of ease of cutting work, sewing work when forming a cylindrical body, and form stability, for example, knitting to warp knitted fabric using elastic yarn obtained by covering nylon yarn with polyurethane yarn, etc. The power net fabric can be exemplified as a particularly suitable example.
[0011]
When forming a cylindrical body using a rectangular cloth body made of biodegradable absorbent material, when rounding a piece of fabric cut to fit the outer peripheral size of the suturing device into a cylindrical shape There are cases where two doughs are stacked and both ends are joined. Such joining is performed by any means such as sewing, melt bonding, and adhesive. When the end portions are overlapped, they may be superposed in a flat state or superposed in a hand-to-hand manner. When these are joined by sewing, it is desirable that the ends of the suture thread before and after the sewn portion are extended to an appropriate length as a tearing thread for tearing and dividing the perforated tearing cutting portion. In this case, when a cylindrical shape is constituted by one piece of cloth, it is necessary to arrange a pair of perforations so as to be positioned at both ends of the stitched portion. After the sewing operation is completed and the fire cut is performed, by pulling the end of the thread upward, or when both ends are sewn and formed into a cylindrical shape, a pair of tearing threads are simultaneously grasped and moved upward. By pulling, the perforated tearing cutting portion is sequentially torn and divided.
When forming the cylindrical body, if it is formed by melt bonding or an adhesive, melt bonding as a tearing thread, or a cord thread of an appropriate length is bonded to the front or rear end of the adhesive part, Alternatively, it is desirable that a cord thread having an appropriate length is bonded to the outer surface of the peripheral surface portion for disposal and removal of the cylindrical body by means such as melt bonding or adhesive.
Sewing thread by sewing, fusion bonding, and cord thread integrated by an adhesive are optional regardless of non-degradability and decomposability, but it is desired to have strength that can withstand such operations.
The yarn end may be connected on the loop.
[0012]
As an automatic suture device for thoracotomy to which the suture prosthesis material according to the present invention is applied, U.S. Pat. S. Examples include Multifire GIA80, Multifire GIA60, GIA50P, GIA90P manufactured by SURGICAL, and proxy mate linear cutters 55 mm and 75 mm manufactured by Ethicon. As an automatic suture device for thoracoscope, U.S. Pat. S. Examples include End GIA (2) 30, End GIA (2) 45, End GIA (2) 60 manufactured by SURGICAL, End Pass End Cutter ETS45, EZ45, etc. manufactured by Ethicon. Application to these suturing devices can be performed by a simple operation of encapsulating a cartridge part of a staple and an anvil part having a staple receiving groove.
[0013]
Hereinafter, although the Example of the suture prosthesis material by this invention is described based on drawing, this invention is not limited to this.
[Example 1]
FIG. 1 shows a suture prosthesis 10 according to Example 1 of the present invention, in which a rectangular nonwoven fabric 11 made of a biodegradable absorbent material is rounded to form a cylindrical body 12, and both ear ends are formed. In the state of being overlapped flatly, the overlapped portion 13 is hand-sewn and comb stitches 14 (wave stitching, rough stitching) are applied, and both ends of the sewing thread are extended to form thread extension portions 15 and 16, respectively. is there. 17 and 17 are perforated tearing cutting portions provided in advance in the tubular nonwoven fabric 11, and are formed in a straight line parallel to the axial direction of the tubular body 12. After the suture prosthesis 10 is mounted on an automatic suturing device and fire cut, the pair of suture extensions 15 or 16 are manually pulled upward, whereby the tearing cutting portions 17 and 17 are simultaneously torn, and the staples are stapled. The remaining part (lower part) as the line reinforcing part and the part to be removed (upper part including the sewing thread) can be easily divided.
[0014]
[Example 2]
FIG. 2 shows a suture prosthesis 20 according to a second embodiment of the present invention, in which a rectangular nonwoven fabric 21 made of a biodegradable and absorbable material is rolled to form a cylindrical body 22, and both side edges are joined together. In the state of being superposed in the shape, sewing 24 is applied to the overlapping portion 23 by hand stitching, and both ends of the sewing thread are extended to form sewing thread extensions 25 and 26, respectively. Reference numerals 27 and 27 are perforated cutting portions provided in advance in the tubular nonwoven fabric 21, and are formed in a straight line parallel to the axial direction of the tubular body 22. After the suture prosthesis 20 is mounted on the automatic suturing device and fire cut, the pair of suture extensions 25 or 26 are manually pulled and lifted to tear the tearing cutting portions 27 and 27 simultaneously. Further, it is possible to easily divide the staple line reinforcing part (lower part) and the other part to be removed (upper part including the sewing thread).
[0015]
[Example 3]
FIG. 3 shows a suture prosthesis 30 according to a third embodiment of the present invention, in which a rectangular nonwoven fabric 31 made of a biodegradable and absorbable material is rolled to form a cylindrical body 32, and both side edges are joined together. In the state of being superposed, the seam 35 is hand-sewn on the overlapped portion 33, and both ends of the thread are extended to form thread extension portions 36 and 37, respectively. Reference numerals 38 and 38 are perforated cutting portions provided in advance for the tubular nonwoven fabric 31, and are formed in a curved shape on the outer peripheral surface of the tubular body 32. After the suture prosthesis 30 is attached to an unillustrated automatic suturing device and fire cut, the pair of suture extensions 35 or 36 are manually pulled and lifted, so that the tearing cutting portions 38 and 38 are simultaneously opened. By tearing, the staple line reinforcing part (lower part) and the other part to be removed (upper part including the sewing thread) can be easily divided.
[0016]
[Example 4]
FIG. 4 shows a suture prosthesis 40 according to Example 4 of the present invention, in which a rectangular nonwoven fabric 41 made of a biodegradable absorbent material is rolled to form a cylindrical body 42, and both ear ends are formed. In the state of being superposed flatly, sewing 45 is applied to the superposed portion 43 by a normal sewing machine, and both end portions of the sewing thread are extended, and sewing thread extensions 46, 46 are formed by lower thread and upper thread, respectively. , 47 and 47 are formed two each. 48 and 48 are perforated cutting portions provided in advance for the tubular nonwoven fabric 41, and are formed in a straight line parallel to the axial direction of the tubular body. After the suture prosthesis 40 is attached to an unillustrated automatic suturing device and fire cut, the pair of suture extensions 46 or 47 are manually pulled and lifted so that the tearing cutting portions 48 and 48 are simultaneously opened. By tearing, the staple line reinforcing part (lower part) and the other part to be removed (upper part including the sewing thread) can be easily divided.
[0017]
[Example 5]
FIG. 5 shows a suture prosthesis 50 according to a fifth embodiment of the present invention, in which a rectangular nonwoven fabric 51 made of a biodegradable absorbent material is rolled to form a cylindrical body 52, and both ear ends are formed. In a state of being superposed flatly, a heater or the like is pressed against the superposed portion 53 to give a melt bond 55, and an appropriate length of cord yarn is melt bonded to both ends of the melt bond portion 55 for pulling. Yarns 56 and 57 are formed respectively. 58 and 58 are perforated tearing cutting portions provided in advance for the tubular nonwoven fabric 51, and are formed in a straight line parallel to the axial direction of the tubular body 52. After attaching the suture prosthetic material 50 to an unillustrated automatic suturing device and performing a fire cut, the pair of pulling threads 56 and 57 are manually pulled and lifted, whereby the tearing cutting portions 58 and 58 are formed. At the same time, it is easily torn, and the staple line reinforcing part (lower part) and the other part to be removed (upper part including the sewing thread) can be easily separated.
[0018]
[Example 6]
FIG. 6 shows a suture prosthetic material 60 according to Example 6 of the present invention, which is a non-woven fabric made of a rectangular biodegradable absorbent material having the same length in the vertical direction and a large length in the width direction. 61 and a stretchable power net fabric 62 having a small length in the width direction are used to form a cylindrical body 63. The both ear ends of the nonwoven fabric 61 and the power net fabric 62 are polymerized in a hand-to-hand manner. In this state, the tubular portions 63 are formed by hand-stitching the overlapping portions 64 and 64 by hand-sewing 65 and 65, respectively. 66 and 67 are sewing thread extensions formed by extending both ends of the sewing thread, and 68 and 68 are a pair of perforated tears provided in advance in the nonwoven fabric 61 having a large size in the width direction (circumferential direction). The cutting section is formed in a straight line parallel to the axial direction of the cylindrical body 63. After the suture prosthesis 60 is mounted on the automatic suturing device and fire cut, the pair of suture extensions 66 or 67 are manually pulled and lifted to tear the tearing cutting portions 68 and 68 simultaneously. Further, it is possible to easily divide the staple line reinforcing part (lower part) and the other part to be removed (upper part including the sewing thread).
[0019]
[Example 7]
FIG. 7 shows a suture prosthesis 70 according to a seventh embodiment of the present invention. A non-woven fabric 71 and a stretchable power net made of a rectangular biodegradable absorbent material having substantially the same length in the longitudinal and width directions. A cylindrical body 73 is formed through the fabric 72, and both the ear ends of the nonwoven fabric 71 and the power net fabric 72 are polymerized in a hand-aligned manner with the normal sewing machine for the polymerization portions 74, 74, The cylindrical body 73 is formed by applying sewing 75 and 75 respectively. Further, 76 and 77 are sewing thread extensions formed by extending both ends of the sewing thread, respectively, and 78 and 78 are a pair of perforated tearing cutting portions provided in advance in the nonwoven fabric 71, and the shaft of the cylindrical body 73. It is formed parallel to the direction and linearly. After the suture prosthesis 70 is attached to the automatic suturing device and fire cut, the pair of suture extensions 76 or 77 are manually pulled and lifted to tear the tearing cutting portions 78 and 78 at the same time. Further, it is possible to easily divide the staple line reinforcing part (lower part) and the other part to be removed (upper part including the sewing thread).
[0020]
[Example 8]
FIG. 8 shows a suture prosthesis 80 according to Example 8 of the present invention. A non-woven fabric 81 and a stretchable power net made of a rectangular biodegradable absorbent material having substantially the same length in the longitudinal direction and the width direction. A cylindrical body 83 is formed through the cloth 82, and an appropriate heater or the like is applied to the overlapping portions 84, 84 in a state where both ear ends of the nonwoven fabric 81 and the power net cloth 82 are polymerized in a hand-to-hand manner. , A melt bond 85 is applied to form a cylindrical body 83, and a cord thread 86 of an appropriate length is appropriately melt bonded on the outer peripheral surface of the power net fabric 82 on the side removed from the body. . Reference numerals 87 and 87 denote perforated tear cutting portions provided in advance in the nonwoven fabric 81, and are formed in a straight line parallel to the axial direction of the tubular body 83. After the suture prosthesis 80 is mounted on the automatic suturing device and fire cut, the cord thread 86 is manually pulled and lifted, whereby the tearing cutting portions 87 and 87 are simultaneously torn and the staple line reinforcing portion ( The lower part) and other parts to be removed (upper part including the sewing thread) can be easily divided.
[0021]
【The invention's effect】
The present invention has a feature that it can prevent air leakage from a resected part or rupture of a soft tissue, especially in an operation using a staple type automatic suturing device, and the material itself is biodegradable and absorbable for a long time. And a pair of perforated tearing cutting portions provide an effect of easily separating the staple line reinforcing portion from the rest.
In addition, when using non-woven fabric made of a relatively stretchable biodegradable and absorbable material, even when used alone, the stretchability makes it easy to attach to and repair the automatic suturing device. After that, the position does not shift due to the expansion and contraction force, and the tension is also applied in the cutting operation after fixing with the staple, so that there is an effect that it can be easily cut.
When the biodegradable absorbent material is not stretchable, the same wearability as described above can be obtained by combination with a stretchable material, and there is an effect that it can be easily cut even in a cutting operation.
[Brief description of the drawings]
FIG. 1 is a schematic perspective view of a suture prosthesis material obtained according to a first embodiment of the present invention.
FIG. 2 is a schematic perspective view of a suture prosthesis material obtained according to a second embodiment of the present invention.
FIG. 3 is a schematic perspective view of a suture prosthesis material obtained according to a third embodiment of the present invention.
FIG. 4 is a schematic perspective view of a suture prosthesis material obtained according to a fourth embodiment of the present invention.
FIG. 5 is a schematic perspective view of a suture prosthesis material obtained according to a fifth embodiment of the present invention.
FIG. 6 is a schematic perspective view of a suture prosthesis material obtained according to a sixth embodiment of the present invention.
FIG. 7 is a schematic perspective view of a suture prosthesis material obtained according to a seventh embodiment of the present invention.
FIG. 8 is a schematic perspective view of a suture prosthesis material obtained according to an eighth embodiment of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Suture prosthesis 11 Nonwoven fabric 12 Tubular body 13 Superposition | polymerization part 14 Cushion stitches 15 and 16 Sewing thread extension part 17 Cutting part for tear

Claims

A suture prosthesis for an automatic suturing device, wherein a tubular body is formed by providing at least a pair of tear perforations on a cloth-like body made of a biodegradable and absorbable material and joining the ear ends of the cloth-like body. Wood.

A suture prosthetic material characterized in that a tubular body is formed by joining a cloth-like body made of a biodegradable absorbent material provided with at least a pair of tear perforations and a stretchable knitted fabric.

The biodegradable absorbent material is polyglycolic acid, polylactic acid, polyparadioxanone, a copolymer of glycolic acid and lactic acid, a copolymer of lactic acid and caprolactone, or a copolymer of glycolic acid and caprolactone. The suture prosthesis material according to 2.

Joining the end of the cloth-like body made of biodegradable absorbent material, or joining the cloth-like body made of biodegradable absorbent material and elastic knitted fabric, woven fabric by sew (wave stitching), The suture prosthetic material according to claim 1, wherein the suture thread end is extended.

The end of the cloth-like body made of the biodegradable absorbent material, or the joint of the cloth-like body made of the biodegradable absorbent material and the elastic knitted fabric is sewn with a sewing machine, and the suture thread The suture prosthesis according to claim 1 or 2, wherein a thread end is extended.

Bonding the end of a cloth-like body made of a biodegradable absorbent material or joining a cloth-like body made of a biodegradable absorbent material and a stretchable knitted fabric with melt bonding, The suture prosthetic material according to claim 1, wherein the suture prosthesis is bonded and bonded.

Bonding the end of a cloth-like body made of a biodegradable absorbent material, or joining a cloth-like body made of a biodegradable absorbent material and a stretchable knitted or woven fabric with an adhesive, and a cord yarn The suture prosthesis according to claim 1, wherein the suture prosthesis is bonded.